Arizona Senior Property Valuation Protection Option (Property Tax)

Senior Property Valuation Protection Option (Property Tax)
Form 82104
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SENIOR PROPERTY VALUATION PROTECTION OPTION
PLEASE CHECK ONE: INITIAL APPLICATION
NOTICE OF REAPPLICATION

APPLICANT: Please read the instructions on the reverse side before completing this form. Complete the form and
copy for your records before submitting it to the County Assessor where your primary residence is located. The form
must be submitted by September 1.
Application Date __________ County ____________ Parcel ID # _____________ Account # _____________
Applicant’s Name(s) ______________________________________ / __________________________________________
Primary Residence Address ___________________________________________ City _____________ Zip ___________
Mailing Address _____________________________________________________ City _____________ Zip ___________

Years lived in primary residence _________ (must be minimum of two years). Provide proof of residency by submitting utility
statements, voter registration, or other documentation of proof as requested by the Assessor.
NOTE: “Primary residence” as defined in Article 9 Section 18 of the Arizona Constitution means all owner occupied real property
and improvements to that real property in this state that is a single family home, condominium or townhouse or an owner occupied
mobile home and that is used for residential purposes. A qualified taxpayer can have only one primary residence.
Are you the sole owner? Yes
No
If co-owned, please state total number of owners ___________________
At least one of the owners must be sixty-five years old. Provide proof of age (birth certificate, driver license, passport, etc.).
Qualified Owner’s date(s) of birth: _____-_____-_____ / _____-_____-_____
INCOME INFORMATION: List total annual income for all owners from all sources, taxable and non taxable, for
the previous three calendar years. Documentation may be requested by the Assessor to verify income.
INCOME FROM ALL SOURCES

Year One _______

Year Two _______

Year Three ______

Salaries, wages, and tips earned.

$

$

$

$

$

$

Social Security benefits received.
Pension and annuity income received.
Dividend and interest income received.
Rent and royalty income received.
Business and farm income received.
Unemployment insurance payments received.
Workmen‘s compensation payments received.
Railroad retirement benefits received.
Veteran’s disability pension payments received.
Alimony payments received.
Estate and trust income received.
Public Assistance payments received.
Other income earned or received.
TOTAL ANNUAL COMBINED INCOME =

Three Year Total Annual Combined Income $ ___________________ Three Year Average $ _________________
Under penalty of perjury, I/we hereby certify that all of the information contained in this application form is true and correct.
I/we consent to the freezing of the valuation of my primary residence for a three year period.
Print Name(s) ________________________________ / ______________________________ Phone ________________
Signature(s) _________________________________ / ________________________________ Date ________________
THIS BLOCK IS FOR COUNTY ASSESSOR USE ONLY
Residency/Age/Income Requirements Met? Yes

No

Limited Property Value Freeze Approved Yes

No

Amount of Three Year Average Income Verified $ _____________ Assessor/Deputy _______________ Date __________
Valuation Protection Option applied to valuation years ________, ________ and ________.
DOR 82104 (Revised 01/2021)

INSTRUCTIONS
SENIOR PROPERTY VALUATION PROTECTION OPTION
Arizona voters approved Proposition 104 in the November, 2000 General Election,
and Proposition 102 in the November, 2002 General Election, thereby amending
the Arizona Constitution. The Amendments provide for the “freezing” of the
valuation of the primary residence of those seniors who meet all of the following
requirements:
1.	 At least one of the owners must be sixty-five years of age at the time the
application is filed. A copy of proof of age must be submitted.
2.	 The property must be the primary residence of the taxpayer. For purposes
	
of this application “Primary residence” as defined in Article 9 Section 18 of the
	
Arizona Constitution means all owner occupied real property and improvements
	
to that real property in this state that is a single family home, condominium
	
or townhouse or an owner occupied mobile home and that is used for residential
	purposes.
3.	 The owner must have resided in the primary residence for at least two years
prior to applying for the option.
4.	 The owner(s) total income from all sources, including non taxable income,
cannot exceed the amount specified by law.
For an initial valuation protection option application, if the owner meets all of these
requirements and the County Assessor approves the application, the valuation of
the primary residence will remain fixed for a three year period.
To remain eligible, the owner is required to renew the valuation protection option
during the last six months of the three year period on receipt of a notice of
reapplication from the County Assessor.
The freeze terminates if the owner sells the home or otherwise becomes ineligible.
The property’s valuation will revert to its current full cash value and limited property
value as determined by the County Assessor in the valuation year in which the sale
is completed.
Please be aware that, while the VALUATION will be frozen for as long as the
owner remains eligible, TAXES for the primary residence will NOT be frozen and
will continue to be levied at the same rate that is applicable to all other properties
in the taxing district.